54例哮喘发作期幼儿的肺功能测定及变应原皮内试验

Pulmonary functions and allergen tests in 54 children with asthma in acute attack

目的探讨哮喘发作期幼儿的肺功能特征及变应原检测结果。方法选择哮喘发作期的54例3-4岁幼儿(哮喘组)进行脉冲振荡肺功能检测,并与同龄健康幼儿30名作对照(对照组)。哮喘组加做支气管舒张试验及变应原皮内试验。结果与对照组相比,哮喘组患儿呼吸总阻抗(Zrs)、5Hz时的气道粘性阻力(R5)、周边气道阻力(Rp)和共振频率(Fres)明显增高,5Hz时的电抗值(X5)明显下降(P<0.01)。哮喘组行支气管舒张试验后,其呼吸阻力测定值较前明显好转,改善率>35%。Zrs、R5、Rp、Fres较舒张前明显下降,X5较舒张前明显上升(P<0.01)。哮喘组变应原检测的阳性率65%。其中,屋尘螨阳性率85.7%、粉尘螨阳性率74.2%、细链格孢霉阳性率42.8%。结论哮喘发作患儿存在呼吸阻力增高和可逆性气道阻塞。屋尘螨、粉尘螨、细链格孢霉是哮喘幼儿最常见的过敏原。

Objective To investigate the characteristics of pulmonary functions and the results of allergen test in children （3-4 years old） with asthma in acute attack. Methods The impulse oscillometry test（IOS） of pulmonary function was performed in 54 children with asthma in acute attack（group A） and 30 healthy children（group C）. The skin prick test for analysis of allergen and bronchial dilatation test were performed in group A as well. Results Compare with group C, Zrs, RS, Fres and Rp were higher, but X5 was lower, significantly in group A（P〈0. 0,1 ）. After bronchial dilatation test, the airway resistance descended by 30% with significant decreases in Zrs, R5, Fres and Rp,and increase in X5（P〈0. 01）. The total positive rate of allergen test was 65% in group A. The positive rate was 85. 7% for Der p,74. 2% for Der f and 42.8% for Alternaria. Conclusion Asthmatic children in acute attack have high respiratory resistance and reversible airway obstruction. Der p,Der f and Alternaria are the most important allergens.